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Traumatic Brain Injury

Traumatic Brain Injury
Traumatic Brain Injury and Closed Head Injury commonly occur due to motor vehicle collisions. Injuries can range from a loss of consciousness of less than five minutes to being comatose for many months. Any level of injury can cause an increase in pre-injury bad driving behaviors or create new, unsafe driving issues. These issues can stem from problems with vision, accuracy and speed of eye movements, speed of response, attention, memory, problem solving, judgment and/or loss of physical skills. It can spare one skill and wipe another skill completely from memory. It commonly makes learning new information difficult and may keep a survivor from quickly learning from their mistakes. All of the above can result in unsafe driving encounters, unpredictable driving actions or repeat collisions for the survivor.If someone you know has been in an accident or has had a TBI, look for the following warning signs:

  • Inappropriate driving speeds
  • Is slow to identify and avoid potentially hazardous situations
  • Needs help or instruction from passengers
  • Doesn’t observe signs or signals or speed limits
  • Leaves out important road, traffic or warning information
  • Slow or poor decisions to traffic or road changes
  • Easily frustrated or confused
  • Pattern of getting lost, even in familiar areas
  • Collisions or near misses
  • Blames their driving mistakes on the behavior of other drivers

If you or those that drive with you notice any of the above warning signs and need a driving evaluation, give us a call at 508-697-6006 and we can, help you with with knowledge about medical conditions, and help with a comprehensive evaluation and determine your ability to drive.

  • Visual Perception
  • Functional Ability
  • Reaction Time
  • Behind-the-wheel evaluation

Multiple Sclerosis

Multiple Sclerosis
Multiple Sclerosis can affect individuals in varying ways including tingling, numbness, slurred speech, blurred or double vision, muscle weakness, poor coordination, unusual fatigue, muscle cramps, bowel and bladder problems and paralysis. Due to these symptoms, special equipment or accommodations may need to be made to aid a person in safely maintaining their mobility independence for as long as possible.

Physical Considerations: The following are considerations for selecting a vehicle:

Driving a sedan: The Individual must be able to do the following:

  • Open and close the Door
  • Transfer in and out of the vehicle
  • A wheelchair/scooter must be able to be stored and retrieved. Special equipment is available to aid with storage.

Driving a Van: Options may include a mini-van with a lowered floor and a ramp or a full size van with a lift. Specialized modifications allow a person to transfer to the driver’s seat or drive from a wheelchair. Technology may be able to compensate for the loss of strength or range of motion such as:

  • Reduced effort steering and/or brake systems to compensate for reduced strength.
  • Mechanical hand controls allow for operation of the gas and brake using upper extremities.
  • Servo brake/ accelerator systems compensate for reduced strength/range of motion of arms.
  • If spasticity is difficult to manage, it may lead to an inability to drive.

Visual Changes:

  • May be severe enough that driving is precluded or night driving is prohibited.
  • If double vision is intermittent and can be monitored independently, then driving may be limited to avoid driving during an exacerbation.
  • Sunglasses may help with glare sensitivity.
  • Compensate for loss of peripheral vision with special mirrors and head turning.
  • Learn order of traffic signals to aid with color vision impairment.

Cognitive Issues:

  • Need to regulate emotions and avoid driving when upset, angry or overly emotional.
  • May be limited to familiar routes if some loss of memory or problem solving but still enough judgment to drive.

Decreased Energy:

  • Energy conservation is vital.
  • May require assistance with wheelchair loading to save energy for driving.
  • Air conditioning aids with managing warm climates.

Medications:

  • Seek the physician’s input regarding side effects which may impair driving.
  • Monitor when medications are taken. Don’t drive when sleepy or just before or after medicating

If you or those that drive with you notice any of the above warning signs and need a driving evaluation, give us a call at 508-697-6006 and we can, help you with with knowledge about medical conditions, and help with a comprehensive evaluation and determine your ability to drive.

  • Visual Perception
  • Functional Ability
  • Reaction Time
  • Behind-the-wheel evaluation

 

Spina Bifida

Spina Bifida
Spina Bifida is a congenital defect in which part of one or more vertebrae (the bone structure that surrounds the spinal column), fail, to develop completely, leaving part of the spinal cord exposed. It can occur anywhere on the spine but is most common in the lower back. The severity of the condition depends on how much nerve tissue is exposed. Frequently special adaptations on a vehicle are necessary for independent driving. The person with Spina Bifida may also have impairments in the ~areas of vision, perception (how the brain interprets what the eyes see) or learning. Adaptive driving equipment is frequently used for physical problems. A spinner knob and hand controls can be used if a person is unable to use either foot for gas or brake. Specialized modifications can also allow a person to transfer to the driver’s seat or drive from the wheelchair in a van or minivan.

Common factors that can affect safe driving:

  • Limited range of motion and strength
  • Difficulty with coordinated movements
  • Visual impairments (poor acuity)
  • Trouble visually scanning or tracking quickly
  • Learning difficulties
  • Impaired judgment in complex situations
  • Slow processing and reaction time

A driver rehabilitation evaluation will examine the strengths and weaknesses of each individual as related to the driving task. The goal is independent, safe driving. No modifications or vehicle selection should be made until the person has completed a driver evaluation.

If you or those that drive with you notice any of the above warning signs and need a driving evaluation, give us a call at 508-697-6006 and we can, help you with with knowledge about medical conditions, and help with a comprehensive evaluation and determine your ability to drive.

  • Visual Perception
  • Functional Ability
  • Reaction Time
  • Behind-the-wheel evaluation

Pass on the Ribbon & Help Spread Rett Syndrome Awareness

Rett Syndrome Awareness Month

Rett syndrome is a rare, severe, “girls only” form of autism. It’s usually discovered in the first two years of life, and a child’s diagnosis with Rett syndrome can feel overwhelming. Although there’s no cure, early identification and treatment may help girls and families who are affected by Rett syndrome.

Who Gets Rett Syndrome?
Rett syndrome is an autism spectrum disorder that affects girls almost exclusively. It’s rare — only about one in 10,000 to 15,000 girls will develop the condition.

In most cases of Rett syndrome, a child develops normally in early life. Between 6 and 18 months of age, though, changes in the normal patterns of mental and social development begin.


What Are the Symptoms of Rett Syndrome?
Although it’s not always detected, a slowing of head growth is one of the first events in Rett syndrome. Loss of muscle tone is also an initial symptom. Soon, the child loses any purposeful use of her hands. Instead, she habitually wrings or rubs her hands together.

Around 1 to 4 years of age, social and language skills deteriorate in a girl with Rett syndrome. She stops talking and develops extreme social anxiety and withdrawal or disinterest in other people.

Rett syndrome also causes problems with muscles and coordination. Walking becomes awkward as girls develop a jerky, stiff-legged gait. A girl with Rett syndrome may also have uncoordinated breathing and seizures.


What Causes Rett Syndrome?
Most children with Rett syndrome have a mutation in a particular gene on the X chromosome. Exactly what this gene does, or how its mutation leads to Rett syndrome, isn’t clear. It’s believed that the single gene may influence many other genes involved in development.

Although Rett syndrome seems to be genetic, the faulty gene is almost never inherited from the parents. Rather, it’s a chance mutation that happens in the girl’s own DNA. No Rett syndrome risk factors have been identified, other than being female. There is no known method for preventing Rett syndrome.

When boys develop the Rett syndrome mutation, they die shortly after birth. Because boys have only one X chromosome (instead of the two girls have), the disease is more serious, and quickly fatal.


How Is Rett Syndrome Diagnosed?
A diagnosis of Rett syndrome is based on a girl’s pattern of symptoms and behavior. The diagnosis can be made on these observations alone. Discussions between a doctor and a girl’s parents will help determine important details, such as when symptoms started.
Genetic testing can help confirm the diagnosis in 80% of girls with suspected Rett syndrome. It’s possible that genetic testing can help predict severity.


Treatments for Rett Syndrome
There are treatments available for Rett syndrome that focus on helping a girl live the best life she can with the condition. Physical therapy can help improve mobility; speech therapy may help somewhat with language problems; and occupational therapy helps girls perform daily activities — like bathing and dressing — independently.

Experts believe that therapy can help girls with Rett syndrome and their parents. Although a “normal” life may not be possible, some improvement can be expected with therapy. Participating in activities — including school — and improved social interaction are sometimes possible.

Medicines can treat some of the problems with movement in Rett syndrome. Medication can also help control seizures. Unfortunately, there is no cure for Rett syndrome.


What to Expect With Rett Syndrome
Many girls with Rett syndrome can be expected to live at least into middle age. Researchers are still following women with the disease, which was only widely recognized in the past 20 years.

Symptoms of Rett syndrome don’t usually improve over time. It is a lifelong condition. Often, there is a very slow worsening of symptoms, or symptoms remain stable. Girls and women with Rett syndrome will rarely be able to live independently.

Early Signs and Symptoms of Multiple Sclerosis

Early Signs and Symptoms of Multiple Sclerosis

Early Signs and Symptoms of Multiple Sclerosis
Multiple Sclerosis early signs, symptoms can be in such a mild form as not to be initially detectable.
MS early symptoms and signs appear at the onset of the disease, usually between the ages of 20 and 40. MS early symptoms and signs vary in duration and severity from one individual to the other and at different times in the same individual.
The most recurrent are:
  • walking difficulties
  • the sensation of having a weak or numb limb
  • cold or tingling feet
  • facial pain (Neuralgia)
  • blurred vision
Less common MS early symptoms include:
  • lack of coordination
  • cognitive difficulties
  • slurred speech
  • sudden onset of paralysis
As the disease progresses other symptoms can appear.
MS pain
MS pain is the type of pain that affects the central nervous system and pain syndromes are common amongst MS patients. Almost 50% of MS patients suffer s from chronic pain. There are several types of MS pain. The main types are:
  • Neuralgia, which is a stabbing pain in the face; it is usually treated with anticonvulsants.
  • Dysesthesias, which is a burning, aching body pain; it is usually treated with anticonvulsants and sometimes with antidepressants which act on the nervous central system.
  • Lhermitte sign, which is a brief, electric shock like sensation that runs down the spine and is caused by bending the neck forward or backward. It is controlled by means of a soft collar.
  • A chronic sensation of ‘pins and needles’, which is treated similarly to acute Dysesthesias.
  • Muscle spasm and cramps, which are treated with anti-inflammatory drugs.
  • Back and skeleton pains, which are treated with heat, massage and physical therapy.